NJ hospital that cut ER use of opioids would become national model, under proposed law

Doctors are cutting back on opioid prescriptions but not by nearly enough, federal health officials say.
Wochit

Dr. Mark Rosenberg, chair of emergency medicine at St. Joseph's University Medical Center in Paterson, helped decrease opioid prescriptions in the emergency deparment by 82% in two years through the Alternatives to Opioids (ALTO) program. Bipartisan legislation in Congress would make the project a national model for other hospitals.(Photo: Amy Newman/NorthJersey.com)

A program that has cut emergency-room prescriptions for opioid painkillers in Paterson to less than a fifth of their previous level in two years could become a model for hospitals nationwide, if a bill proposed by New Jersey's two senators and a congressman is passed.

Standing outside the emergency department of St. Joseph's University Medical Center on Monday, Sens. Bob Menendez and Cory Booker and Rep. Bill Pascrell Jr. said their proposed law has achieved something very unusual in Congress these days: support from Republicans and Democrats in both houses.

"We have momentum, not just in this community but on a national level," Booker said of the measure, which would allocate $10 million a year for three years to fund demonstration projects based on the St. Joseph's model of alternatives to opioids for treating emergency patients.

With the fourth-busiest emergency department in the country, St. Joseph's has been widely praised for its program to use alternatives to prescription pills like Percocet and OxyContin to treat patients who arrive with injuries from falls or car accidents or pain caused by kidney stones or sciatica.

In two years, opioid prescriptions dropped from 4,376 in the six months before the program began to 746 in the six months ending in February. Depending on their complaint, patients now are treated with combinations of non-addictive drugs, nerve blocks, trigger-point injections or other methods.

"We've added more tools to the toolbox," said Dr. Mark Rosenberg, who conceived the program as the hospital's chairman of emergency medicine. Pain is treated aggressively, using protocols that are based on scientific evidence, he said.

U.S. Senators Cory Booker (D-NJ) and Bob Menendez (D-NJ) and U.S. Rep. Bill Pascrell, Jr. (D-NJ-09) announced their bipartisan federal legislation that would provide emergency departments with the resources they need to combat the opioid crisis. They stood outside the emergency entrance to St. Joseph's University Medical Center in Paterson.(Photo: Amy Newman/NorthJersey.com)

Those protocols will be shared with other hospitals under the legislation being considered in Congress.

"The last thing I go to now is Percocet," Rosenberg said. Avoiding the use of opioid-based painkillers from the start of treatment eliminates the opportunity for patients to misuse the drugs or become dependent on or addicted to them, he said. Patients' pain is treated better and they are more satisfied, he added.

Pascrell said the St. Joseph's program, which has also been adopted at St. Joseph's Wayne Hospital, AtlantiCare Regional Medical Center, Jersey City Medical Center and hospitals in Colorado and Florida, should become "a blueprint" for others.

More than 42,000 people died in 2016 from opioid overdoses, including more than 2,000 in New Jersey. Forty percent of the deaths were attributed to prescription drugs. Four out of five heroin users start with prescription drugs.

The epidemic affects people of all incomes, ages and communities.

"It's hard to meet any New Jerseyans who haven't been touched," said Menendez. He pledged to "fight like hell" to make sure New Jersey gets its fair share of the $6 billion appropriated in the most recent federal budget to deal with the opioid epidemic.

Senator Cory Booker (D-NJ), pictured and Senator Bob Menendez (D-NJ) and U.S. Representative Bill Pascrell, Jr. (D-NJ-09), not pictured, announced their bipartisan federal legislation that would provide emergency departments with the resources they need to combat the opioid crisis.The Alternatives to Opioids (ALTO) in the Emergency Department Act would establish a national demonstration program, based on the successful ALTO model pioneered at St. Joseph’s Medical Center, to implement alternative pain management protocols to limit the use of unnecessary opioids in emergency departments both here in New Jersey and across the country on Monday, April 23, 2018.(Photo: Amy Newman/NorthJersey.com)